African-American urban ministers functioning as pastoral counselors constitute an engaging and useful group with experiences and skills that can be tapped by interested secular professionals. Their work represents a significant mental health resource for persons who lack sufficient access to needed care.

While mental health consumers have begun to assess the effectiveness of services they receive, they have yet to be included in the formulation of policies that determine the services and service systems to be developed in the future. This report examines consumer perspectives on the major policy direction of the past 40 years, deinstitutionalization, finding that a vast majority of consumers express a preference for community over hospital living. This examination identifies a number of complexities involved in the integration of consumer input into policy decisions. The authors suggest strategies to resolve these issues and highlight remaining questions concerning the role of consumer perspectives in the formulation of mental health policy.

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